Diabetes Prevention Program

Marshalltown YMCA-YWCA

Partnerships & DPP

WHY? Importance of partnerships & engagement

…the process of working collaboratively with & through groups of people affiliated by geographic proximity, special interest, or similar situations to address issues affecting the well-being of those people. It is a powerful vehicle for bringing about environmental and behavioral changes that will improve the health of the community and its members. It often involves partnerships and coalitions that help mobilize resources and influence systems, change relationships among partners, and serve as a catalyst for changing policies, programs and practices.

(CDC, 1997, p9)

Mobilize

Resources:

Partners

Influence Systems:

Break Barriers

Change

Relationships:

Outcomes

Mobilize Resources:

Partners

The Diabetes Prevention Program has proven results, but for the program to work

you need successful partnerships.

DPP in Marshalltown (early stages)

2011 Pilot Class—Staff outreach to hospital & physician clinics & Public Health

2012 Community Transformation Grant—Spanish class at Iowa Valley Community

College’s Education & Training Center (community partner)

Creation of a DPP Community Advisory Committee—engage stakeholders

Organizational leadership & support needed—’a marathon’

How can others be engaged? • Advisory Committee—champions • Prospective Funder • Referral Partner-engage leaders • Community Supporter/ Connector • Access/Site Location • Program Champion-past participant • Volunteer/Outreach-presentations Find out what will work for them to support you

GRASS ROOTS OR TOP DOWN APPROACH? The “bottom up approach” (grass roots) must be simultaneous with the “top-down approach” in order to reach consistent and sustainable results. MUST DO BOTH

Getting Started with DPP

Engaging partners in a community health

initiative: Identify Partners

Community

•Community-based organizations

•Faith-Based

•Senior Centers

•Public Health

Healthcare

•Healthcare systems

•Clinics

•Hospitals

•Medical associations

•Community Health Coalitions

PARTNERSHIP DEVELOPMENT: WHO?

Co

mm

un

ity

Ad

vis

ory

Co

mm

itte

e

Marshalltown Y DPP Advisory Committee

• Chair: Retired physician, interest in population health

• Hospital leadership (CEO, executive level staff)

• Physician clinic leadership

• Public Health representative

• Corporate/major employer representative

• Dietician/diabetes educator

• Y Board member

• Y CEO

• Community volunteer with a passion for health

• Health & Wellness Director

• DPP Coordinator

Influence Systems:

Breakdown Barriers

What keeps DPP participants from engaging & being successful?

Paper referral forms –where healthcare provider (HCP) provides patient with a referral to bring to the Y or patient provides consent for HCP to share their information with the Y (via paper form) •Point of Care (POC) Referrals-referred at office visit Electronic referrals –where patient provides consent for HCP to share their information with the Y (electronically) via the Electronic Medical Record system –HCP is prompted in the EMR to fill out a referral any time a patient’s blood value falls into prediabetes range Website portals –website includes a link for you to enter secure patient referrals via physician or healthcare provider or self referral *Utilize this method to increase program enrollment and begin to set up sustainability.

REFERRAL MECHANISMS (via YMCA of the USA)

• Healthcare providers flag eligible participants • Retrospective letters –query, letter sent to identified

patients • Prompts or Standing orders –staff in the clinical setting

are prompted to screen/refer individuals with certain risk factors for prediabetes-done at Point of Care (POC)

• Paper referral • Electronic Referral

*May be based on who you are working with and what they are capable of, start with where they are at.

REFERRAL MECHANISMS (via YMCA of the USA)

ESTABLISHING ONGOING REFERRALS •Set up HIPAA secure e-referral system •Your partners view you as a trusted source of care, so you must be responsive to referrals they send you. •Make available multiple resources to support program promotion: patient referrals, brochures, flyers, etc. (although a little goes a long way) •Referral systems can be built from the healthcare provider to your organization, that can also ensure HIPAA compliance •Provide progress reports on your participating participants, at various points throughout the program (to physicians & Community Advisory Committee) Partners that can help with integration: •Hospital/Clinic Community Outreach Staff •Pharmacists and/or Pharmaceutical Representatives •Clinic Office Managers

REFERRAL MECHANISMS (via YMCA of the USA)

• Sustainability-need 3rd party payers (insurance, employer,

etc.)

• Finding a model that motivates self-pay

• Community demographics

• Changing leadership-organizational & partners

Challenges

•Grant funding

•Moving toward third-party payer

system and Medicare reimbursement

•Seen as leader in community health

Successes

Change Relationships:

Outcomes

Marshalltown Y DPP is a CDC recognized program & part of integrated healthcare.

YMCA’s Diabetes Prevention Program is a year-long program that

challenges participants to reduce total body weight by 7% and

increase physical activity to 150 minutes/week.

*Originally offered in 2011, there are currently two classes running

and two classes recently completed at the Marshalltown Y.

*The Diabetes Prevention Recognition Program (DPRP) sets high

standards diabetes prevention programs must reach to obtain CDC

recognition. Program areas tracked by DPRP include: percentage

participants with a pre-diabetes blood value, sessions with body

weight recorded, session with physical activity minutes recorded,

number of session attended in the first 6 months of the program,

average percentage weight loss at 6 months, number of sessions

attended in months 7-12, and average percentage weight loss at 12

months. CDC recognition is required for Medicare reimbursement.

Marshalltown Y DPP

Class Name Start Date Program Stage Thurs 5:30pm 10/19/2017 Session 24 Thurs 12pm 10/4/2018 Session 0

Marshalltown Y DPP

Testimonials are important!

Story #1 is from a current Marshalltown Y DPP participant—

“When I signed up for this program I was very pessimistic on what it would provide me. I

knew all the right foods and special amounts to eat, as we all think. As the first class

started I found out that I didn't really know all that much. I didn't know the average intake

of fats should only be 50 grams. With that said I dropped weight that first few weeks like

crazy. I also meet a group of people who are dealing with the same problems of incorrect

information or frustration with their bodies and themselves. In every meeting I am reassured

that I am not the only one going through this and that this life style change is hard across

all age ranges. The support that I get from the members of this group and the leaders of the

program is amazing. As I said, when I started I was pessimistic and now I can't imagine

trying to gather all of this information or trying to apply it on my own.

Thanks for letting me create a healthier me.”

Marshalltown Y DPP

Testimonials are important!

Story #2 is from a Des Moines participant (through a shared-service agreement with the Des Moines Y)—

“My A1C results have went from 6.4 three months ago to a 5.2 as of yesterday. The

doctor said all of my numbers look great and at this point she says I’m not even

considered pre-diabetic. Thank you for all you do—I really enjoy the class and you have

helped make this an easy transition. Still a ways to go on my goals but one less worry

for the time being.””

Marshalltown Y DPP

Marshalltown Y DPP 2017 Data Class Name Start Date Program Stage

Tue 5:30pm 7/18/2017 Session 9

Wed. 5:30pm 3/1/2017 Session 21

Tue. 12pm 10/4/2016 Completed 9/5/2017

Tue. 5:30pm 10/4/2016 Completed 9/19/2017

Marshalltown Y DPP

? QUESTIONS?

Marshalltown Y Diabetes Prevention Program